The Vernon C. Neal Sportsplex

THE VERNON C. NEAL SPORTSPLEX

200 Dunn Ave.– Washington, PA 15301

Phone: 724-222-2522 – FAX: 724-222-2550

FALL 2017YOUTH FLAG FOOTBALL

Age Groups

6-8 and 9-12(All Co-ed)

$80.00 per player / $65.00 per player**

**If you have your red & white reversible jersey from

our previousFlag Football Leagues

No refunds unless league is cancelled! May combine age divisions!

THREE WAYS TO REGISTER

REGISTER IN PERSONon Wed., Aug.30from 6-7:30PM or on Tue.,Sept. 5from

6-7:30 PM at the Vernon C. Neal Sportsplex

REGISTER BY MAILsend the registration form below in the mail to the address above

REGISTER ONLINEat and mail a check to the address above. (Make check payable to the Vernon C. Neal Sportsplex)

DEADLINE TO REGISTER & PAY: September5, 2017

Registration is valid only if payment is received by Sept. 5, 2017

Games will be played thru the week and on the weekends

PLAYER REGISTRATION FORM

Player Name ______Age Group ______Birth Date ______

School District ______Shirt Size YM YL AS AM AL AXL

Parents Name ______

Address ______City/State/Zip ______

Home Phone ______Work Phone ______

Cell Phone ______E-Mail ______

My son/daughter has my permission to participate in the youth flag football league, during the time his group is scheduled. I will not hold any adult advisor or anyone responsible for any injury or illness that might occur during practice sessions, games or in transit. I agree to indemnify and save harmless the Vernon C. Neal Sportsplex and Brownson House from any and all liability or damages they may be required to pay for my child. I certify my son/daughter has been examined and is physically fit to participate.

Does the child have hospitalization? Yes _____No ______

Parent Signature: ______Date: ______

Would like to request a certain coach ______

Would like to play on the same team as ______